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Marital Status: -- Select -- Never Married Divorced Widowed Legally Separated   What age range are you looking to date: Select 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75+ To Select 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75+   My relationship goal:  -- Select -------------------- Casual Dating/Friendship Steady/Long-term Relationship Marriage   My social situation: (check all that apply)   I'm new to the area I don't want to settle for second best I don't feel comfortable asking people out Safety concerns me I'm really busy with work I'm tired of people playing games I meet a lot of people, just not the right type I'm a single parent I don't like the bar scene I'm very selective of whom I'll date       Do you have children?   Yes, livingwith me Yes, living with me sometimes Yes, grown and out of the house No       Would you date someone with children?   Yes No Maybe Tell you later       Would you like to have children?   Yes No Unsure Tell you later       Which of the following ways have you used to meet people? (check all that apply)   Friends Online Personals Chance Bars/Nightclubs Work Matchmaking Service Video Dating Service Singles Events Church/Synagogue Social Groups School Other       What, if any, issues did you encounter when using an online dating site?   Inaccurate Profiles Safety Concerns Misleading Photos Not everyone was serious Many people didn't respond Rude responses from people Too many people to respond to Not everyone was single Other:       What are some problems you have had in previous romantic partners? (Things you definitely want to stay away from!)   Over Jealous Incompatibility Different Goals Infidelity Financial Management Different lifestyle Too Controlling Different Interests Lack of affection Trust Lack of commitment Lack of communication Moody Different Values Sexual Incompatibility Self Image Different religious beliefs Parental Viewpoints Other        What is the single biggest thing that has been missing in the people you have been meeting?         If you were to meet someone for a quality long-term relationship, what are the most important traits you would like to find in a partner? (Click up to 10)   Honest Romantic Kind Friendly Respectful Enthusiastic Witty Thoughtful Affectionate Spiritual Genuine Passionate Intelligent Ambitious Physically Fit Outgoing Compassionate Energetic Health Conscious Fun Organized Loyal Happy Dependable Level Headed Grounded Neat Modest Funny Goal Directed Determined Perceptive Good Listener Spontaneous Successful Calm       Is meeting someone special for a loving relationship TRULY a top priority in your life?   Yes    No       If we were to introduce you to someone great from our membership, tell us when you could set aside a couple of hours to meet them. (check all that apply)   Lunch Afternoons Evenings Weekends Anytime - my time is my own       Which of the following best describes how you feel about talking with a relationship specialist? --> --> Select One <-- <-- Excited - I know I need to try something new Ok - I'm always open to explore new ideas A little uncomfortable - This is something new to me Nervous - This whole process feels very awkward       You could be close to meeting some fantastic people that you would never meet on your own, so..."What special qualities do you possess that would make us feel good about introducing you to our members?"         Help us understand what you really want. Looking out three years from now, What will need to happen for you to feel happy about the progress you've made in your personal life?         By telling us a little more about yourself, your representative will have a better idea of what you are looking for in someone. The clearer we understand your wants and needs, the better your chances of finding the right person. We will always respect your privacy!